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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Would insulin help the kidney condition?

Hi, I am writting from Mexico, I am a writting on behalf of my husband a 58 year old diabetic for the past 10 or 15 years. I have laboratory test with following results:
December 7/10
Glucose 163.60mg/dl Creatinine 2.18mg/dl Urea 108.97mg/dl
December 15th/10 Creatinine 1.6mg/dl Urea 103.41mg/dl
December 22nd/10 Creatinine 2.05mg/dl Urea 112.66mg/dl
December 29/10 Creatinine 2.19mg/dl Urea 87.55mg/dl

He is been on Merformin to control diabetes recently on May 2010 was put on high blood pressure pills. He had two hospitalizations:
2008 Summay Diagnosis
Left foot ulcers, Concern for avascular necrosis vs osteomyelitis, peripheral vascular disease, Diabetes Mellitus, tye 11, hypertension, renal insuffficiency, hyperkalemia.
2010 Hospitalization
Left foot ulcer with exposed bone, osteomyelitis involving the left fifth metatarsal, peripheral vascular disease, Type 2 Diabetes mellitus, hypertension, hyperkalemia.
The Dr. we are consulting wants to change the suger pill for insulin. He explained to us that sugar pill only works for so long. I am starting him on insuline, my question is? Would the insuline help him with his kidney condition, should I be worried about his kidneys- Right now he has swollen feet and ankles, and cramps on his legs and a rash in his back. Concerned wife. Jacky
Wed, 3 Sep 2014
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Diabetologist 's  Response
Dear Jacky
i can understand your concern
i am very sorry about the condition of your husband
in my opinion considering the change from oral pills to insulin is the best advice given by your doctor
At the level of creatinine more than 1.6mg/dl we need to stop metformin and should consider taking insulin for control of blood sugar as at that level of renal damage metformin will be more harmful.
insulin helps in recovery of kidney to certain extent.
the reason for hyperkalemia is due to decreased kidney function.
i suggest you to use leached vegetables and meet your nephrologist to prescribe this kind of potassium binding resins.
swollen feet might be due to water retention due to reduced kidney function
he will be alright in no time
regards
Dr vamsi
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